Hostname: page-component-78c5997874-ndw9j Total loading time: 0 Render date: 2024-11-20T00:42:21.772Z Has data issue: false hasContentIssue false
  • English
  • Français

The Pain Catastrophizing Scale—short form: psychometric properties and threshold for identifying high-risk individuals

Published online by Cambridge University Press:  20 February 2019

Sheung-Tak Cheng Open the ORCID record for Sheung-Tak Cheng [Opens in a new window] ,
Phoon Ping Chen ,
Yu Fat Chow ,
Joanne W. Y. Chung ,
Alexander C. B. Law ,
Jenny S. W. Lee ,
Edward M. F. Leung  and
Cindy W. C. Tam
Sheung-Tak Cheng*
Affiliation:
Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong Department of Clinical Psychology, Norwich Medical School, University of East Anglia, Norwich, UK
Phoon Ping Chen
Affiliation:
Department of Anaesthesiology & Operating Services, Alice Ho Miu Ling Nethersole Hospital, Hong Kong
Yu Fat Chow
Affiliation:
Department of Anaesthesiology & Operating Theatre Services, Queen Elizabeth Hospital, Hong Kong
Joanne W. Y. Chung
Affiliation:
Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong
Alexander C. B. Law
Affiliation:
Department of Medicine and Geriatrics, Princess Margaret Hospital, Hong Kong
Jenny S. W. Lee
Affiliation:
Department of Medicine, Alice Ho Miu Ling Nethersole Hospital, Hong Kong
Edward M. F. Leung
Affiliation:
Department of Medicine and Geriatrics, United Christian Hospital, Hong Kong
Cindy W. C. Tam
Affiliation:
Department of Psychiatry, North District Hospital, Hong Kong
*
Correspondence should be addressed to: Sheung-Tak Cheng, Department of Health and Physical Education, The Education University of Hong Kong, 10 Lo Ping Road, Tai Po, N.T., Hong Kong. Email: [email protected].
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

The Pain Catastrophizing Scale (PCS) measures three aspects of catastrophic cognitions about pain—rumination, magnification, and helplessness. To facilitate assessment and clinical application, we aimed to (a) develop a short version on the basis of its factorial structure and the items’ correlations with key pain-related outcomes, and (b) identify the threshold on the short form indicative of risk for depression.

Design:

Cross-sectional survey.

Setting:

Social centers for older people.

Participants:

664 Chinese older adults with chronic pain.

Measurements:

Besides the PCS, pain intensity, pain disability, and depressive symptoms were assessed.

Results:

For the full scale, confirmatory factor analysis showed that the hypothesized 3-factor model fit the data moderately well. On the basis of the factor loadings, two items were selected from each of the three dimensions. An additional item significantly associated with pain disability and depressive symptoms, over and above these six items, was identified through regression analyses. A short-PCS composed of seven items was formed, which correlated at r=0.97 with the full scale. Subsequently, receiver operating characteristic (ROC) curves were plotted against clinically significant depressive symptoms, defined as a score of ≥12 on a 10-item version of the Center for Epidemiologic Studies-Depression Scale. This analysis showed a score of ≥7 to be the optimal cutoff for the short-PCS, with sensitivity = 81.6% and specificity = 78.3% when predicting clinically significant depressive symptoms.

Conclusions:

The short-PCS may be used in lieu of the full scale and as a brief screen to identify individuals with serious catastrophizing.

Keywords

pain catastrophizingchronic paindepressive symptomsolder adults
Type
Original Research Article
Information
International Psychogeriatrics , Volume 31 , Issue 11: Issue Theme: Psychiatric Morbidity in Exceptionally Old People , November 2019 , pp. 1665 - 1674
Copyright
© International Psychogeriatric Association 2019 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Abu-Saad Huijer, H., Fares, S. and French, D. J. (2017). The development and psychometric validation of an Arabic-language version of the Pain Catastrophizing Scale. Pain Research & Management, Art ID: 1472792. doi: 10.1155/2017/1472792.Google Scholar
Andresen, E. M., Malmgren, J. A., Carter, W. B. and Patrick, D. L. (1994). Screening for depression in well older adults: evaluation of a short form of the CES-D. American Journal of Preventive Medicine, 10, 77–84.CrossRefGoogle Scholar
Asparouhov, T., Muthén, B. and Muthén, B. (2006). Robust chi square difference testing with mean and variance adjusted test statistics. Matrix, 1, 1–6.Google Scholar
Azevedo, L. F., Costa-Pereira, A., Mendonca, L., Dias, C. C. and Castro-Lopes, J. M. (2012). Epidemiology of chronic pain: a population-based nationwide study on its prevalence, characteristics and associated disability in Portugal. The Journal of Pain: Official Journal of the American Pain Society, 13, 773–783. doi: 10.1016/j.jpain.2012.05.012.CrossRefGoogle Scholar
Bair, M. J., Robinson, R. L., Katon, W. and Kroenke, K. (2003). Depression and pain comorbidity: a literature review. Archives of Internal Medicine, 163, 2433–2445.CrossRefGoogle ScholarPubMed
Bansal, D., Gudala, K., Lavudiya, S., Ghai, B. and Arora, P. (2016). Translation, adaptation, and validation of Hindi version of the Pain Catastrophizing Scale in patients with chronic low back pain for use in India. Pain Medicine, 17, 1848–1858.CrossRefGoogle ScholarPubMed
Bernfort, L., Gerdle, B., Rahmqvist, M., Husberg, M. and Levin, L. A. (2015). Severity of chronic pain in an elderly population in Sweden–impact on costs and quality of life. Pain, 156, 521–527. doi: 10.1097/01.j.pain.0000460336.31600.01.CrossRefGoogle Scholar
Broderick, J. E. et al. (2016). Cognitive behavioral therapy for chronic pain is effective, but for whom? Pain, 157, 2115–2123. doi: 10.1097/j.pain.0000000000000626.CrossRefGoogle ScholarPubMed
Brown, T. A. (2006). Confirmatory Factor Analysis for Applied Research. New York, NY: Guilford Press.Google Scholar
Carmody, T. P. et al. (2013). Telephone-delivered cognitive-behavioral therapy for pain management among older military veterans: a randomized trial. Psychological Services, 10, 265–275. doi: 10.1037/a0030944.CrossRefGoogle ScholarPubMed
Carnes, D. et al. (2012). Effective delivery styles and content for self-management interventions for chronic musculoskeletal pain: a systematic literature review. The Clinical Journal of Pain, 28, 344–354. doi: 10.1097/AJP.0b013e31822ed2f3.CrossRefGoogle ScholarPubMed
Chen, Q., Hayman, L. L., Shmerling, R. H., Bean, J. F. and Leveille, S. G. (2011). Characteristics of chronic pain associated with sleep difficulty in older adults: the Maintenance of Balance, Independent Living, Intellect, and Zest in the Elderly (MOBILIZE) Boston study. Journal of the American Geriatrics Society, 59, 1385–1392.CrossRefGoogle ScholarPubMed
Cheng, S.-T. and Chan, A. C. M. (2005). The center for epidemiologic studies depression scale in older Chinese: Thresholds for long and short forms. International Journal of Geriatric Psychiatry, 20, 465–470. doi: 10.1002/gps.1314.CrossRefGoogle ScholarPubMed
Cheng, S.-T. and Chan, A. C. M. (2008). Detecting depression in Chinese adults with mild dementia: findings with two versions of the Center for Epidemiologic Studies Depression Scale. Psychiatry Research, 159, 44–49. doi: 10.1016/j.psychres.2007.06.023.CrossRefGoogle ScholarPubMed
Cheng, S.-T., Chan, A. C. M. and Fung, H. H. (2006). Factorial structure of a short version of the center for epidemiologic studies depression scale. International Journal of Geriatric Psychiatry, 21, 333–336. doi: 10.1002/gps.1467.CrossRefGoogle Scholar
Cheng, S.-T. et al. (2018). The relationship of self-efficacy to catastrophizing and depressive symptoms in community-dwelling older adults with chronic pain: a moderated mediation model. PLoS One, 13, e0203964–e0203964. doi: 10.1371/journal.pone.0203964.CrossRefGoogle ScholarPubMed
Cho, S., Kim, H. and Lee, J. (2013). Validation of the Korean version of the Pain Catastrophizing Scale in patients with chronic non-cancer pain. Quality of Life Research: An International Journal of Quality of Life Aspects of Treatment, Care & Rehabilitation, 22, 1767–1772. doi: 10.1007/s11136-012-0308-2.CrossRefGoogle ScholarPubMed
DiStefano, C., Liu, J., Jiang, N. and Shi, D. (2018). Examination of the weighted root mean square residual: evidence for trustworthiness? Structural Equation Modeling, 25, 453–466.CrossRefGoogle Scholar
El-Gabalawy, R., Mackenzie, C., Thibodeau, M., Asmundson, G. and Sareen, J. (2013). Health anxiety disorders in older adults: conceptualizing complex conditions in late life. Clinical Psychology Review, 33, 1096–1105.CrossRefGoogle ScholarPubMed
Fishbain, D. A., Lewis, J. E., Gao, J., Cole, B. and Steele Rosomoff, R. (2009). Is chronic pain associated with somatization/hypochondriasis? An evidence-based structured review. Pain Practice, 9, 449–467.CrossRefGoogle ScholarPubMed
Flora, D. B. and Curran, P. J. (2004). An empirical evaluation of alternative methods of estimation for confirmatory factor analysis with ordinal data. Psychological Methods, 9, 466–491. doi: 10.1037/1082-989X.9.4.466.CrossRefGoogle ScholarPubMed
Hanley, J. A. and McNeil, B. J. (1983). A method of comparing the areas under receiver operating characteristic curves derived from the same cases. Radiology, 148, 839–843. doi: 10.1148/radiology.148.3.6878708.CrossRefGoogle ScholarPubMed
Hoffman, B. M., Papas, R. K., Chatkoff, D. K. and Kerns, R. D. (2007). Meta-analysis of psychological interventions for chronic low back pain. Health Psychology, 26, 1.CrossRefGoogle ScholarPubMed
İlçin, N. et al. (2016). Cross-cultural adaptation and validation of the Turkish version of the Pain Catastrophizing Scale among patients with ankylosing spondylitis. Journal of Physical Therapy Science, 28, 298–303. doi: 10.1589/jpts.28.298.CrossRefGoogle ScholarPubMed
Kelley, K. (2018, January 10). MBESS: The MBESS R Package. R package version 4.4.3. Available at: https://CRAN.R-project.org/package=MBESS; last accessed 27 November 2018.Google Scholar
Larsson, C., Hansson, E., Sundquist, K. and Jakobsson, U. (2017). Chronic pain in older adults: prevalence, incidence, and risk factors. Scandinavian Journal of Rheumatology, 46, 317–325.CrossRefGoogle Scholar
Lei, P. and Wu, Q. (2012). Estimation in structural equation modeling. In Hoyle, R.H. (eds.), Handbook of Structural Equation Modeling (pp. 164–180). New York, NY: Guilford Press.Google Scholar
López-Lopez, A., González, J. L., Alonso-Fernández, M., Cuidad, N. and Matías, B. (2014). Pain and symptoms of depression in older adults living in community and in nursing homes: the role of activity restriction as a potential mediator and moderator. International Psychogeriatrics, 26, 1679–1691. doi: 10.1017/S1041610214000970.CrossRefGoogle ScholarPubMed
MacCallum, R. C., Browne, M. W. and Sugawara, H. M. (1996). Power analysis and determination of sample size for covariance structure modeling. Psychological Methods, 1, 130.CrossRefGoogle Scholar
Marcus, D. K., Gurley, J. R., Marchi, M. M. and Bauer, C. (2007). Cognitive and perceptual variables in hypochondriasis and health anxiety: a systematic review. Clinical Psychology Review, 27, 127–139.CrossRefGoogle ScholarPubMed
McDonald, R. P. (1999). Test Theory: A Unified Treatment. Mahwah, NJ: Lawrence Erlbaum.Google Scholar
Miró, J., Nieto, R. and Huguet, A. (2008). The Catalan version of the Pain Catastrophizing Scale: a useful instrument to assess catastrophic thinking in whiplash patients. The Journal of Pain, 9, 397–406. doi: 10.1016/j.jpain.2007.12.004.CrossRefGoogle ScholarPubMed
Osman, A., Barrios, F. X., Kopper, B. A., Hauptmann, W., Jones, J. and O’Neill, E. (1997). Factor structure, reliability, and validity of the Pain Catastrophizing Scale. Journal of Behavioral Medicine, 20, 589–605. doi: 10.1023/A:1025570508954.CrossRefGoogle ScholarPubMed
Park, J. and Hughes, A. K. (2012). Nonpharmacological approaches to the management of chronic pain in community-dwelling older adults: a review of empirical evidence. Journal of the American Geriatrics Society, 60, 555–568.CrossRefGoogle ScholarPubMed
Pfeiffer, E. (1975). A short portable mental status questionnaire for the assessment of organic brain deficit in elderly patients. Journal of the American Geriatrics Society, 23, 433–441.CrossRefGoogle Scholar
R Core Team. (n.d.). R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. Available at: https://www.R-project.org/; last accessed 27 November 2018.Google Scholar
Ruscheweyh, R., Nees, F., Marziniak, M., Evers, S., Flor, H. and Knecht, S. (2011). Pain catastrophizing and pain-related emotions: influence of age and type of pain. The Clinical Journal of Pain, 27, 578–586. doi: 10.1097/AJP.0b013e31820fde1b.CrossRefGoogle Scholar
Sanders, J. B., Comijs, H. C., Bremmer, M. A., Deeg, D. J. H. and Beekman, A. T. F. (2015). A 13-year prospective cohort study on the effects of aging and frailty on the depression-pain relationship in older adults. International Journal of Geriatric Psychiatry, 30, 751–757. doi: 10.1002/gps.4224.CrossRefGoogle ScholarPubMed
Sehn, F. et al. (2012). Cross-cultural adaptation and validation of the Brazilian Portuguese version of the Pain Catastrophizing Scale. Pain Medicine, 13, 1425–1435. doi: 10.1111/j.1526-4637.2012.01492.x.CrossRefGoogle ScholarPubMed
Somers, T. J., Kurakula, P. C., Criscione-Schreiber, L., Keefe, F. J. and Clowse, M. E. (2012). Self-efficacy and pain catastrophizing in systemic lupus erythematosus: relationship to pain, stiffness, fatigue, and psychological distress. Arthritis Care & Research, 64, 1334–1340.CrossRefGoogle ScholarPubMed
Sullivan, M. J. L., Bishop, S. R. and Pivik, J. (1995). The Pain Catastrophizing Scale: development and validation. Psychological Assessment, 7, 524–532. doi: 10.1037/1040-3590.7.4.524.CrossRefGoogle Scholar
Tang, N. K. and Crane, C. (2006). Suicidality in chronic pain: a review of the prevalence, risk factors and psychological links. Psychological Medicine, 36, 575–586.CrossRefGoogle ScholarPubMed
Trizano-Hermosilla, I. and Alvarado, J. M. (2016). Best alternatives to Cronbach’s alpha reliability inrealistic conditions:congeneric and asymmetrical measurements. Frontiers in Psychology, 7, 769. doi: 10.3389/fpsyg.2016.00769.CrossRefGoogle ScholarPubMed
Turner, J. A., Jensen, M. P. and Romano, J. M. (2000). Do beliefs, coping, and catastrophizing independently predict functioning in patients with chronic pain? Pain, 85, 115–125.CrossRefGoogle ScholarPubMed
Van Damme, S., Crombez, G., Bijttebier, P., Goubert, L. and Van Houdenhove, B. (2002). A confirmatory factor analysis of the Pain Catastrophizing Scale: invariant factor structure across clinical and non-clinical populations. Pain, 96, 319–324. doi: 10.1016/S0304-3959(01)00463-8.CrossRefGoogle ScholarPubMed
Von Korff, M., Ormel, J., Keefe, F. J. and Dworkin, S. F. (1992). Grading the severity of chronic pain. Pain, 50, 133–149.CrossRefGoogle ScholarPubMed
Wetherell, J. L., Petkus, A. J., Alonso-Fernandez, M., Bower, E. S., Steiner, A. R. W. and Afari, N. (2016). Age moderates response to acceptance and commitment therapy vs. cognitive behavioral therapy for chronic pain. International Journal of Geriatric Psychiatry, 31, 302–308. doi: 10.1002/gps.4330.CrossRefGoogle ScholarPubMed
Woby, S., Watson, P., Roach, N. and Urmston, M. (2005). Coping strategy use: does it predict adjustment to chronic back pain after controlling for catastrophic thinking and self-efficacy for pain control? Journal of Rehabilitation Medicine, 37, 100–107.Google ScholarPubMed
Wood, B. M., Nicholas, M. K., Blyth, F., Asghari, A. and Gibson, S. (2016). The mediating role of catastrophizing in the relationship between pain intensity and depressed mood in older adults with persistent pain: a longitudinal analysis. Scandinavian Journal of Pain, 11, 157–162. doi: 10.1016/j.sjpain.2015.12.009.CrossRefGoogle ScholarPubMed
Xu, X. et al. (2015). Validation of a simplified Chinese version of the Pain Catastrophizing Scale and an exploration of the factors predicting catastrophizing in pain clinic patients. Pain Physician, 18, E1059–E1072.Google ScholarPubMed
Yap, J.C. et al. (2008). Validation of the Chinese Pain Catastrophizing Scale (HK-PCS) in patients with chronic pain. Pain Medicine, 9, 186–195. doi: 10.1111/j.1526-4637.2007.00307.x.CrossRefGoogle ScholarPubMed
Youden, W.J. (1950). Index for rating diagnostic tests. Cancer, 3, 32–35.3.0.CO;2-3>CrossRefGoogle ScholarPubMed